Dikkat eksikliği/ hiperaktivite bozukluğu olan çocuklarda metilfenidat yanıtı ile ilişkili faktörler: Retrospektif bir çalışma

Amaç: Bu çalışmada dikkat eksikliği ve hiperaktivite bozukluğu olan çocuklarda (DEHB) klinik özelliklerin ve öz-kavramının metilfenidat (MTF) yanıtı üzerine etkilerinin araştırılması amaçlanmıştır.Yöntem: Çalışma naturalistik desende yapılmış olup sonuçlar geriye dönük olarak değerlendirilmiştir. DEHB ve komorbid bozuklukların tanısı Okul Çağı Çocukları İçin Duygulanım Bozuklukları ve Şizofreni Görüşme Çizelgesi Şimdi ve Yaşam Boyu Şekli-Türkçe Uyarlaması (ÇGDBŞÖ-ŞY) ile konulmuştur. İlk görüşmede ebeveynlere Turgay DSM-IV'e dayalı Yıkıcı Davranış Bozukluklarını Tarama ve Değerlendirme Ölçeği (T-DSM-IVYDDÖ) ve Çocuk ve Gençler için Davranış Değerlendirme Ölçeği (ÇDDÖ) uygulanmıştır. Öğretmenler T-DSMIV-YDDÖ ve ÇDDÖ'ni doldurmuşlardır. Çocuklar ise Piers-Harris'in Çocuklarda Öz-kavramı Ölçeği (PHÇÖÖ), Çocuklarda Depresyon Ölçeği (ÇDÖ) ve Çocuklarda Anksiyete Tarama Ölçeği (ÇATÖ) ile değerlendirilmişlerdir. MTF tedavisini takiben ebeveynlere tekrar T-DSM-IV-YDDÖ uygulanmıştır. DEHB belirtilerindeki düzelme klinisyen tarafından Klinik Global İzlenim-İyileşme ölçeği ile değerlendirilmiştir. Çalışmaya toplam 54 çocuk (18 kız, 36 erkek; yaş ortalaması 9.32±0.21 yıl) dahil edilmiştir. Örneklem yazarlar tarafından belirlenen kriterlere göre "iyi yanıt verenler" (İY) ve "yetersiz yanıt verenler" (YY) olarak iki gruba bölünerek karşılaştırılmıştır.Bulgular: YY grubunda İY grubuna göre anksiyete bozuklukları sıklığı ve ortalama içevurum skorları anlamlı olarak daha yüksek, öz-kavramı skoru ise anlamlı olarak daha düşük bulunmuştur. Çoklu regresyon analizinde eşlik eden anksiyete bozukluğu, eşlik eden dışa atım bozukluğu varlığı ve olumsuz öz-kavramı düşük MTF yanıtının öngörücüleri olarak bulunmuştur.Sonuç: Bu çalışmanın sonuçları DEHB'ye eşlik eden anksiyete bozukluğu, inkontinans veya olumsuz öz-kavramı varlığında MTF tedavisine ek tedavi seçeneklerine ihtiyaç olduğunu göstermektedir

Factors Related to Methylphenidate Response in Children with Attention Deficit/ Hyperactivity Disorder: A Retrospective Study

Factors related to methylphenidate response in children with attention deficit/ hyperactivity disorder: a retrospective studyObjective: We aimed to explore the predictive value of clinical features and self-concept on methylphenidate (MPH) response in children with attention deficit/hyperactivity disorder (ADHD).Methods: The study had a naturalistic design where the results were analyzed retrospectively. ADHD and comorbidity were diagnosed by Schedule for Affective Disorders and Schizophrenia for School-Age Children Present Lifetime Version (K-SADS-PL). At the baseline assessment, parents completed Turgay DSM-IV Disruptive Disorders Rating Scale (T-DSM-IV-S) and Child Behavior Check List (CBCL); teachers were given T-DSM-IV-S, CBCL. The children completed Piers-Harris Children’s Self-Concept Scale (PHSCS), Children’s Depression Inventory (CDI), and Screen for Child Anxiety Related Emotional Disorders (SCARED). Following 4-8 weeks of MPH treatment, the parents completed T-DSM-IV-S and the clinician completed Clinical Global Impression-Improvement scale (CGI-I). This study included 54 children (18 girls, 36 boys; mean age 9.32±0.21 years old). The sample was divided in “good responders” (GR) and “poor responders” (PR) regarding the response criteria defined by authors.Results: The PR group had significantly higher rates of anxiety disorders, higher internalizing scores and lower PHSCS scores compared to GR. Comorbid anxiety disorders, elimination disorders and negative selfconcept were found to predict poor MPH response by multiple regression analysis. Conclusions: The results point to the need for additional interventions in the presence of comorbid anxiety, incontinence or poor self-concept in children with ADHD

Kaynakça

1. Barkley RA. International consensus statement on ADHD. J Am Acad Child Adolesc Psychiatry 2002; 41:1389. [CrossRef]

2. Goldman L, Genel M, Bezman R, Slanetz PJ. Diagnosis and treatment of attention-deficit/hyperactivity disorder in children and adolescents. Council on Scientific Affairs, American Medical Association. JAMA 1998; 279:1100-1107. [CrossRef]

3. American Academy of Pediatrics. Subcommittee on AttentionDeficit/Hyperactivity Disorder and Committee on Quality Improvement. Clinical practice guideline: treatment of the school-aged child with attention-deficit/hyperactivity disorder. Pediatrics 2001; 108:1033-1044. [CrossRef]

4. Kutcher S, Aman M, Brooks SJ, Buitelaar J, van Daalen E, Fegert J, Findling RL, Fisman S, Greenhill LL, Huss M, Kusumakar V, Pine D, Taylor E, Tyano S. International consensus statement on attention-deficit/hyperactivity disorder (ADHD) and disruptive behaviour disorders (DBDs): clinical implications and treatment practice suggestions. Eur Neuropsychopharmacol 2004; 14:11-28. [CrossRef]

5. Pliszka SR, Crismon ML, Hughes CW, Corners CK, Emslie GJ, Jensen PS, McCracken JT, Swanson JM, Lopez M; Texas Consensus Conference Panel on Pharmacotherapy of Childhood Attention Deficit Hyperactivity Disorder. The Texas Children’s Medication Algorithm Project: revision of the algorithm for pharmacotherapy of attention-deficit/hyperactivity disorder. J Am Acad Child Adolesc Psychiatry 2006; 45:642-657. [CrossRef]

6. Barbaresi WJ, Katusic SK, Colligan RC, Weaver AL, Leibson CL, Jacobsen SJ. Long-term stimulant medication treatment of attention-deficit/hyperactivity disorder: results from a populationbased study. J Dev Behav Pediatr 2006; 27:1-10. [CrossRef]

7. Pliszka S; AACAP Work Group on Quality Issues. Practice parameter for the assessment and treatment of children and adolescents with attention-deficit/hyperactivity disorder. J Am Acad Child Adolesc Psychiatry 2007; 46:894-921. [CrossRef]

8. Buitelaar JK, Van der Gaag RJ, Swaab-Barneveld H, Kuiper M. Predication of clinical response to methylphenidate in children with attention-deficit hyperactivity disorder. J Am Acad Child Adolesc Psychiatry 1995; 34:1025-1032. [CrossRef]

1. Barkley RA. International consensus statement on ADHD. J Am Acad Child Adolesc Psychiatry 2002; 41:1389. [CrossRef]

2. Goldman L, Genel M, Bezman R, Slanetz PJ. Diagnosis and treatment of attention-deficit/hyperactivity disorder in children and adolescents. Council on Scientific Affairs, American Medical Association. JAMA 1998; 279:1100-1107. [CrossRef]

3. American Academy of Pediatrics. Subcommittee on AttentionDeficit/Hyperactivity Disorder and Committee on Quality Improvement. Clinical practice guideline: treatment of the school-aged child with attention-deficit/hyperactivity disorder. Pediatrics 2001; 108:1033-1044. [CrossRef]

4. Kutcher S, Aman M, Brooks SJ, Buitelaar J, van Daalen E, Fegert J, Findling RL, Fisman S, Greenhill LL, Huss M, Kusumakar V, Pine D, Taylor E, Tyano S. International consensus statement on attention-deficit/hyperactivity disorder (ADHD) and disruptive behaviour disorders (DBDs): clinical implications and treatment practice suggestions. Eur Neuropsychopharmacol 2004; 14:11-28. [CrossRef]

5. Pliszka SR, Crismon ML, Hughes CW, Corners CK, Emslie GJ, Jensen PS, McCracken JT, Swanson JM, Lopez M; Texas Consensus Conference Panel on Pharmacotherapy of Childhood Attention Deficit Hyperactivity Disorder. The Texas Children’s Medication Algorithm Project: revision of the algorithm for pharmacotherapy of attention-deficit/hyperactivity disorder. J Am Acad Child Adolesc Psychiatry 2006; 45:642-657. [CrossRef]

6. Barbaresi WJ, Katusic SK, Colligan RC, Weaver AL, Leibson CL, Jacobsen SJ. Long-term stimulant medication treatment of attention-deficit/hyperactivity disorder: results from a populationbased study. J Dev Behav Pediatr 2006; 27:1-10. [CrossRef]

7. Pliszka S; AACAP Work Group on Quality Issues. Practice parameter for the assessment and treatment of children and adolescents with attention-deficit/hyperactivity disorder. J Am Acad Child Adolesc Psychiatry 2007; 46:894-921. [CrossRef]

8. Buitelaar JK, Van der Gaag RJ, Swaab-Barneveld H, Kuiper M. Predication of clinical response to methylphenidate in children with attention-deficit hyperactivity disorder. J Am Acad Child Adolesc Psychiatry 1995; 34:1025-1032. [CrossRef]

33. Birmaher B, Khetarpal S, Brent D, Cully M, Balach L, Kaufman J, Neer SM. The Screen for Child Anxiety Related Emotional Disorders (SCARED): scale construction and psychometric characteristics. J Am Acad Child Adolesc Psychiatry 1997; 36:545-53. [CrossRef]

34. Karaceylan Cakmakci F. Validity and Reliability study of Screen for Child Anxiety-Related Emotional Disorder. Unpublished Expertise Thesis, Department of child and adolescent psychiatry Kocaeli University, Faculty of Medicine, Kocaeli, 2004. (Turkish)

35. Guy W. Clinical global impressions. ECDEU assessment manual for psychopharmacology, revised. Rockville, 1976, 218-219.

36. Barkley RA. A review of stimulant drug research with hyperactive children. J Child Psychol Psychiatry 1997; 18:137- 165. [CrossRef]

37. Efron D, Jarman FC, Barker MJ. Child and parent perceptions of stimulant medication treatment in attention deficit hyperactivity disorder. J Paediatr Child Health 1998; 34:288-292. [CrossRef]

38. Greenhill LL, Swanson JM, Vitiello B, Davies M, Clevenger W, Wu M, Arnold LE, Abikoff HB, Bukstein OG, Conners CK, Elliott GR, Hechtman L, Hinshaw SP, Hoza B, Jensen PS, Kraemer HC, March JS, Newcorn JH, Severe JB, Wells K, Wigal T. Impairment and deportment responses to different methylphenidate doses in children with ADHD: The MTA titration trial. J Am Acad Child Adolesc Psychiatry 2001; 40:180-187. [CrossRef]

39. Spencer T, Biederman J, Wilens T, Harding M, O’Donell D, Griffen S. Pharmacotherapy and attention-deficit hyperactivity disorder across the life cycle. J Am Acad Child Adolesc Psychiatry 1996; 35:409-432. [CrossRef]

40. Biederman J. Attention-deficit/hyperactivity disorder: a selective overview. Biol Psychiatry 2005; 57:1215-1220. [CrossRef]

41. Busch B, Biederman J, Cohen LG, Sayer JM, Monuteaux MC, Mick E, Zallen B, Faraone SV. Correlates of ADHD among children in pediatric and psychiatric clinics. Psychiatr Serv 2002; 53:1103-1111. [CrossRef]

42. Pliszka SR. Patterns of psychiatric comorbidity with attentiondeficit/hyperactivity disorder. Child Adolesc Psychiatric Clin N Am 2000; 9:525-540.

43. Ghanizadeh A. Comorbidity of enuresis in children with attention-deficit/hyperactivity disorder. J Atten Disord 2010; 13:464-467. [CrossRef]

44. Houck G, Kendall J, Miller A, Morrell P, Wiebe G. Self-concept in children and adolescents with attention deficit hyperactivity disorder. J Pediatr Nurs 2011; 26:239-247. [CrossRef]

Kaynak Göster

  • ISSN: 1018-8681
  • Yayın Aralığı: Yılda 4 Sayı
  • Başlangıç: 1984

5.3b 3.3b

Sayıdaki Diğer Makaleler

Dikkat eksikliği/ hiperaktivite bozukluğu olan çocuklarda metilfenidat yanıtı ile ilişkili faktörler: Retrospektif bir çalışma

Gökçe Nur SAY, Koray KARABEKİROĞLU, Murat YÜCE

Psychological Symptoms Related with Violence and Its Relationship with Internalizing and Externalizing Problems Among 10th Grade Students

Cüneyt EVREN, Ercan DALBUDAK, Bilge EVREN, MÜGE BOZKURT, Arzu Ciftci DEMİRCİ, FATMA YEŞİM CAN

Erişkin Asperger Sendromu: Olgu sunumu

FERDİ KÖŞGER, Sinem SEVİL, Zafer SUBASİ, Cem KAPTANOĞLU

Romatoid artriti olan kadın hastada hidroksiklorokin kullanımına bağlı gelişen akut psikotik bozukluk: Olgu sunumu

Ebru ALTINTAŞ

Eskişehir Osmangazi Üniversitesi öğrencilerinde sigara, alkol ve madde kullanım yaygınlığı

ALİ DAYİ, GÜLCAN GÜLEÇ, FEZAN MUTLU

Pharmacological Treatment Options for Alcohol Use Disorder

Cüneyt EVREN, MÜGE BOZKURT

Duchenne muskuler distrofisi tanısı olan çocukların yaşam ve uyku kaliteleri ile annelerinin anksiyete düzeyi: Bir olgu kontrol çalışması

GONCA ÖZYURT, Erhan BAYRAM, Pakize KARAOĞLU, Semra Hız KURUL, Uluç YİŞ

Genital herpetik veziküllerle başvuran bir olgunun cinsel istismar yönünden değerlendirmesi

GONCA ÖZYURT, Baris GULLER, Burak BAYKARA, Özlem GENÇER, AYLİN ÖZBEK

Suicide Attempt with Mad Honey: Case Report

Erhan AKINCI

İnfertil çiftlerde cinsiyete göre algılanan sosyal destekle anksiyete ve depresif belirtilerin ilişkisi

Seçil ALDEMİR, Ayla ESER, Nilgün Öztürk TURHAN, Ercan DALBUDAK, MERVE TOPCU